We propose to analyze cancer patient referral patterns in the Puget Sound Region to provide useful information for Cancer Control activities that affect referral decisions and choice of care locations. One product of the study would be a description of the current referral patterns and a set of referral rates that characterizes each community together with a ranking of each community by referral rate. These will be presented to interested groups, including physicians, hospital boards and administrators, health planning groups, and those involved in cancer control. A second product would be a preliminary evaluation of the influence that various medical, demographic, and health resource factors have had on referral rates and patterns in the Puget Sound Region. A third product would be a methodology in the form of a guidebook for calculating referral rates and describing referral patterns in other regions that have population-based incidence and referral data available (such as the SEER locations.)